In the opioid crisis, here's what it takes to save a life

As a fire chief and first responder, Jan Rader has spent her career saving lives. But when the opioid epidemic hit her town, she realized they needed to take a brand-new approach to life-saving. In this powerful, hopeful talk, Rader shows what it's like on the front lines of this crisis -- and how her community is taking an unusual new approach to treating substance-abuse disorder that starts with listening.

For the past 24 years,
I have been a firefighter

in Huntington, West Virginia.

As firefighters, my team and I
are tasked with saving lives

and property

from such disasters
as car wrecks, house fires

and also life-threatening
medical emergencies.

I am a woman leading a department
in a male-dominated profession.

And 10 years ago,

I decided to increase my medical knowledge
and I received a nursing degree.

That was because it became clear

that the next big threat
facing not only my city,

but other cities around the country,

was not the one-and-done disaster,

where you can ride in
like the cavalry, as a firefighter,

put out the fire and leave,
feeling like you have made a difference

and everything is OK.

The next big disaster in my city
was and is the long, debilitating

and lethal disaster
known as opioid addiction.

We now call this a health epidemic,

and we have replaced the name "addiction"
with "substance use disorder."

To give you some perspective

of how significant
this epidemic has become,

in 2017, in my county of 95,000 people,

we saw 1,831 overdoses

[and] 183 deaths from overdose.

This is the job of my firefighters,
as well as other agencies,

to respond to that.

(Coughs)

Excuse me.

So, watching this epidemic
unfold for several years,

I developed some insight.

For this disaster, we need to redefine
our job as a first responder.

We need to be more than just the cavalry.

We need to do more than just save a life.

We need to find ways to rebuild that life.

And it's going to take
a lot of people to do that.

And that is exactly
what we are trying to do

in Huntington, West Virginia.

Now, let me give you some insight
as to what we do.

First, this is what happens
when somebody overdoses.

Imagine you are somebody who is suffering
from the brain disorder of addiction.

You are fragile.

You're embarrassed, you're ashamed.

And you overdose.

Maybe a friend
or a family member calls 911.

And then all of a sudden,

you are awakened by five or six
total strangers in uniform.

And they're rubbing your sternum,

and they're saying, "Wake up, wake up!

You overdosed, you could've died."

Now, would you not be defensive and angry?

Because I know I would be.

And on top of that,

those strangers gave you
a dose of naloxone,

which has sent you into withdrawals,

or what is better known
as "dope sickness."

Dope sickness makes you feel
absolutely horrible.

Some say it's like the flu, times ten.

Nausea, vomiting, diarrhea, body aches.

So not only did we,
as strangers, wake you up,

but we also made you feel really sick.

So in turn, you, the patient,
are not going to be very kind to us.

And you're going to refuse
further medical treatment.

OK, well, then that's going to frustrate
the heck out of us,

and we're going to be mad,

because you're ungrateful
that we just saved your life.

This is not a good dynamic here.

What we are dealing with
is a brain disorder

that changes your thinking.

It convinces you
that you don't have a problem.

So, this might have been not only
the first time you've overdosed,

it might have been the third,
fourth or fifth time

that we, personally, have revived you.

This is not a good situation.

Second,

first responders do not receive
much education

on what substance use disorder is.

Neither does the medical community.

We're not trained how to deal with those
suffering from substance use disorder.

I am trained to put out
many different types of fires.

I am trained to save a life in the moment.

But I am not trained to deal
with the intricate interaction

between first responders,
the health care community,

social services

and the wider community that is necessary
to save a life long-term.

Thirdly,

and this hits home.

As a first responder,
I consider myself the cavalry.

We're knights in shining armor.

We want to swoop in, do our job
and leave feeling satisfied

that we've made a difference
in somebody's life.

But that just doesn't happen

when we're dealing with somebody
with substance use disorder.

We leave feeling frustrated and useless.

We deal with the same people
over and over again,

with no positive outcome.

And you know what?

At some point, I realized
that it is up to us as first responders

and as a community

to solve this problem,

to find better ways to deal
with those that are suffering.

So what I did is I started
observing more on overdoses.

I started talking
and listening to my patients.

I wanted to know
what led them to where they are.

What exactly are they experiencing?

What makes their situation worse?

What makes their situation better?

I began experimenting with my words

and paying attention to my own actions

and how it affected those of my patients.

The education that I have received

and continue to receive
on a street level in Huntington

has been both eye-opening
and life-changing for me.

So, in Huntington, West Virginia,
we have come together as a community,

and we are changing the way that we treat

those that suffer
from this horrible disease.

We have started many programs,
and it's making a difference.

I'll tell you about just a few of those.

Last year, we started
a Quick Response Team,

QRT for short.

The team consists of a paramedic,

a police officer,

somebody in the recovery community
and somebody in the faith community.

As a team, they go out
and visit people who have overdosed

within 72 hours of that resuscitation.

They talk.

They listen.

They build a rapport with that patient,

and they offer them treatment options.

Right now, about 30 percent
or up to 30 percent

of those that the Quick Response Team
have reached out to

have accepted some form of help.

And the wonderful thing about this

is the first responders
who are involved in this team,

they actually feel
like they can make a difference.

Positive change where there wasn't any.

This year --

(Applause)

This year, we opened a free-standing
specialty clinic, called PROACT,

for those suffering
from substance use disorder.

It's a one-stop shop, if you will.

A patient comes in,

they're immediately assessed
by somebody who's an addiction specialist.

They work with them
to provide treatment options

based on their own needs,
individual needs.

This does several things for us.

It gives first responders a place
to either take or refer our patients

who are no longer
in a life-threatening situation,

that have refused to go to the hospital.

And it also clears up

the overwhelmed emergency rooms
in hospitals that we have.

The third thing
that I want to tell you about

is very dear to me
and very important to my team.

We recently started
a first responders self-care program.

More and more ...

first responders are experiencing
compassion fatigue and PTSD.

It is not uncommon for the average
firefighter in Huntington

to deal with or see
up to five young deaths per month.

These are their friends,
these are their classmates.

So this much-needed program
will not only recognize their hard work,

it's going to give them a voice.

It's going to provide them with training

that will help deal with the stress
that they are under.

And it will give them
more mental-health options

that they desperately need.

We now have yoga classes in fire stations.

(Laughter)

(Applause)

We've also provided on-duty
massages, which is fabulous.

(Laughter)

And we have some off-duty programs
that we've started,

like cooking classes for first responders
and their significant other

and pottery classes.

So a couple of months ago,

I walked out on the apparatus floor,
where I had some firefighters.

And half of them had had a massage,

and the other half were getting
ready to have a massage.

And I saw 10 firefighters
who were bantering

in a very positive, relaxed manner.

And I hadn't seen that in years.

And that relaxed state is trickling down
to the community, to the citizens.

So a couple of weeks ago,
I had a neighbor overdose.

Twenty-two years old.

So of course, I hurried down
to help my firefighters and my neighbor.

And what I witnessed
was my firefighters being supportive.

Talking in a non-judgmental way.

I watched as one of my firefighters

showed the father
and another family member

how to provide rescue breaths,
should this happen again.

And left him with a bag valve mask.

Positive change.

Positive change.

Did I happen to mention

the two things that firefighters
dislike the most?

The way things are and change.

(Laughter)

You know, I recognize that there have been
drug epidemics before.

And I've seen what crack
can do to a community.

A lot of our critics think

that this new compassionate response
that we're doing in Huntington

is because of race.

That because the overdoses are happening
so much to the white community.

And I understand that criticism,

because we as a country messed up.

And we treated black people poorly
during the crack epidemic.

We can't forget that.

And we must do better.

But right now, what I know
is people are dying.

And we in Huntington deal with people
suffering from substance use disorder

of every color and every background,
on the streets, every day.

The job of a first responder:
prevent unnecessary deaths.

Period.

So ...

Obviously, I'm a stubborn
firefighter and nurse.

And I refuse to believe that there isn't
a way around every barrier.

One of the barriers that we have

dealing with the opioid
epidemic is stigma.

So ...

We in Huntington, West Virginia,
are showing the rest of the country

that change can happen.

That there is hope
dealing with this epidemic.

Our current overdoses are down 40 percent.

(Applause)

Currently, our overdose deaths
are down 50 percent.

(Applause)

This epidemic is far from over.

But each and every one of us
has a part to play in this epidemic.

Just by listening
and being kind to somebody,

you have the ability
to make a difference in their lives.

Thank you and God bless.

(Applause)